Are You Walking Enough?

Modern life seems to be characterized by sedimentary humans. Because of technological advances and how humankind has evolved, most people no longer have to spend all day plowing the fields, walking distances to work, or do any strenuous physical activity as part of their daily routine. While this may mean people have to exert less energy to produce more, being sedentary for long periods can cause health complications.

In a 2015 study, researchers investigated the association between sedentary time and hospitalizations, all-cause mortality, cardiovascular disease, diabetes, and cancer in adults independent of physical activity [1]. The researchers found all-cause mortality, cardiovascular disease incidence, cancer mortality, cancer incidence, and type-2 diabetes incidence were significantly associated with low levels of physical activity. The researchers concluded, “Prolonged sedentary time was independently associated with deleterious health outcomes regardless of physical activity,” meaning even though an individual may work out or exercise, being sedentary for long periods dramatically increases risk of harmful health outcomes [1].

The researchers developed an unreserved recommendation based on their research: sit less.

Daily walking is a great strategy to break up the monotony of sitting and will have short- and long-term paybacks.

A 2012 study published in The Lancet also examined this phenomenon [2]. Researchers estimated physical activity causes 6% of the burden of disease from coronary heart disease, 7% of type-2 diabetes, 10% of breast cancer, and 10% of colon cancer, worldwide. Further, inactivity causes 9% of premature mortality or 5.3 million deaths worldwide in 2008. If physical activity also decreased by 25% worldwide, there would be an increased death rate of 1.3 million deaths a year, and if physical activity were eliminated entirely, the life expectancy of the world’s population would increase by .68 years [2].

Where Did the 10,000 Steps a Day Recommendation Originate?

If you have ever purchased a fitness tracking device or downloaded a fitness tracking or health app, I am sure you have noticed the default recommended minimum daily step count is 10,000, but where did that number originate?

This number was pulled from thin air during a 1965 Japanese marketing campaign by the Yasama Clock and Instrument Company to promote its Manpo-kei pedometer, which translated to “10,000 steps meter” [3]. Further, the Japanese character for 10,000 resembles a person walking: 一万.

So, this recommendation has no scientific backing, but rather, it was part of a mid-1900s, Japanese marketing campaign.

What Does Science Say?

On May 29, 2019, research was published that examined the association of step volume and intensity with all-cause mortality in older women [4]. The study included 16,741 women with an average age of 72 years (range of 62 to 101), and steps were measured over seven days through an accelerometer.

The researchers found that compared to women who took an average of 2,718 steps, women who took 4,363 steps a day on average (SDA) were 41% less likely to die within the next four years, women who took 5,905 SDA were 46% less likely to die within the next four years, and women who took 8,442 SDA were 58% less likely to die within the next four years [4].

The benefits reached a limit of 7,500 after which where there was no measurable increased benefit for more steps, which showed the benefits increased progressively between 4,400 and 7,500 SDA [4].

The researchers also examined the importance of intense walking and found that higher intensities were associated with lower risks of mortality. However, the intensity benefits nearly disappeared when the gain was adjusted for SDA, meaning step count matters more than intensity in older adults [4].

Additional Studies

You may hold any sort of walking is better than none, and while that may be minimally true, there seems to be a minimum level of physical activity before you receive any of these benefits. Moreover, studies also show that there are benefits associated with walking and movement, up to a point. Therefore, there seems to be an agreement that there is a minimum threshold for the primary benefits to begin and a maximum threshold where any further walking or exercise does not provide additional benefits.

We will review some of these studies now.

In a 2018 study, researchers investigated the relationship between walking and total mortality in older adults [5]. They found that compared to inactivity, walking 120 minutes a week may reduce mortality risk. Further, 150 to 300 minutes of moderate activity per week in the form of walking, decreased all-cause mortality by 20%. The authors concluded, “Walking was most strongly associated with respiratory disease mortality followed by cardiovascular disease mortality and then cancer mortality” [5].

In a 2018 study published in the British Journal of Sports Medicine, researchers investigated the association between walking pace and cause-specific mortality, including modifying factors such as total physical activity volume, highest physical activity intensity, age, sex, and body mass- index (BMI) in 50,225 participants [6]. Compared to slow walking, individuals who walked at an average pace was associated with a 20% reduced risk of all-cause mortality and a 24% reduced risk of cardiovascular disease mortality [6], and walking at a brisk pace increased to 24% but decreased to 21% for all-cause and cardiovascular disease mortality, respectively [6].

In 2010, researchers determined the years of life gained after the age of 40 associated with various levels of physical activity [7]. The researchers found that brisk walking for up to 75 minutes a week was associated with a gain of 1.8 years in life expectancy. Higher levels of physical activity were associated with more significant benefits, with brisk walking for 450 minutes a week being associated with a gain of 4.5 years of life expectancy. When considering BMI levels, being active and healthy weight was associated with an increase of 7.2 years of life expectancy, when compared to being inactive and obese [7].

Studies have also investigated the effects of walking in individuals with health conditions, such as smoking, type-2 diabetes, chronic obstructive pulmonary disease (COPD), and stroke risk.

According to Medical News Today, “ex-smokers increased their life expectancy by 5.6 years and reduced their all-cause mortality by 43 per cent [sic]” and “smokers that participated in physical activity had an increased life expectancy of 3.7 years and a reduction in all-cause mortality of 23 per cent [sic]” [8].

A 2003 study investigated the relationship of walking to mortality among United States adults with diabetes [9]. The researchers found that compared to inactive adults, those who walked at least two hours a week had a 39% lower all-cause mortality rate and a 34% lower cardiovascular disease mortality rate, with the mortality rates being the lowest for people who walked three to four hours a week. The authors concluded, “Walking was associated with lower mortality across a diverse spectrum of adults with diabetes. One death per year may be preventable for every 61 people who could be persuaded to walk at least 2 h/wk” [9].

A 2014 study found that patients with COPD who walked two miles a day or more daily decreased their chances of being hospitalized from a severe episode by approximately 50% [10].

Finally, a 2014 study quantified how physical activity levels and walking is associated with stroke risk. They found there was a dose-response: men who walked four to seven hours a week had an 11% lower risk of stroke; walking eight to fourteen hours lowered risk by 37%; walking fifteen to twenty-one lowered risk by 37%; walking more than twenty-two lowered risk by 64% [11].

Intensity Can Be a Beneficial Factor

Walking can be an effective way to enter into moderate and intense exercise, and studies have shown that switching between gentle and vigorous walking can lead to more enormous benefits than just walking at a conventional pace [12].

A 2015 study investigated the relationship between moderate to vigorous physical activity on all-cause mortality in middle-aged and older people. The study included 204,542 adults, with ages ranging from 45 to 75 years old. The researchers found, “Among people reporting any activity, there was an inverse dose-response relationship between proportion of vigorous activity and mortality,” meaning the more vigorous the physical activity was, the more effective it was at decreasing mortality risk [13].

Therefore, shorter periods of high-intensity exercise offer many of the same benefits of more extended, less-intense exercise.

What Should Be the Goal?

According to 2017 research published in Nature, the average American takes 4,774 steps [14], and considering the average American is very unhealthy and 70% of Americans take at least one prescription medication, I would recommend aiming higher than 4,774 point.

A 2004 study investigated the physical activity in an Old Order Amish community [15]. The researchers found that Amish men took 18,425 SDA and women took 14,196 SDA. The researchers also stated their high level of physical activity contributed to their exceptional health and low obese rates [15].

It is tough to develop a set point of physical activity because people are very different, so make a point to walk more every day, and see where your step count is.

For me, my average daily step count is in the 5,000s, and I am making it a point to get it above 8,500, at the very least.

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